Due to the extremely competitive nature of medical school admissions in the United States, many applicants opt to obtain their medical education in the Caribbean. To provide context, the admit rate at St. George’s Medical School in Grenada, West Indies, is 41%. This contrasts markedly with the admit rates at the most selective medical schools in the U.S., such as Harvard, with admit rate of 3.7%, Johns Hopkins of 3.9% and Stanford, at 4.7%.
To help you decide if attending these schools would be the best option for you, let’s evaluate their curriculum, accreditation, admission requirements, residency outcomes, and the overall success of their graduates.
St. George’s Medical School. Source: The New York Times
Choose Wisely: Regional vs. Offshore
Caribbean medical schools fall into one of two categories: regional or offshore.
- Regional medical schools train students to practice in the country or region where the school is located, and are typically the choice for Caribbean residents who wish to practice in their home country.
- Offshore medical schools in the Caribbean predominantly train students from the United States and Canada who intend to return home for residency and clinical practice after graduation. Most offshore schools are dual-campus programs, where students spend their first two years of medical school in the Caribbean learning basic sciences and prepare for Step 1 of the USMLE (United States Medical Licensing Examination). Their clinical years are then spent in the United States. Offshore schools find clinical rotations for their students through partnering agreements with U.S. hospitals.
The first factor to consider is that not all Caribbean medical schools are accredited and not all have access to clinical rotations. So before you decide to attend a particular medical school in the Caribbean, make sure that the schools you are considering will allow you to practice and attend clinical rotations in the United States.
Beware of medical schools that use the terms “approved” or “recognized,” which do not connote accreditation. In addition, make sure that the schools have received the official accreditations that truly matter:
- Caribbean Accreditation Authority for Education in Medicine and Health Professions (CAAM-HP): a peer review process adopted by CARICOM (Caribbean Community) to accredit educational institutions within the medical, dental, veterinary and other health professions. Of the 17 medical schools in the Caribbean that requested assessment over recent years from CAAM-HP, only American University of Antigua, St. George’s, and Ross have been accredited.
- Other countries’ accreditation. Several Caribbean medical schools are located on islands that are owned or accredited by other countries. American University of the Caribbean School of Medicine (AUC), based in St. Maarten, is accredited by Accreditation Commission on Colleges of Medicine (ACCM), in Ireland, recognized by the the US DOE’s National Committee on Foreign Medical Education and Accreditation (see below). Saba University School of Medicine (located in the Dutch island of Saba), is accredited by NVAO, the accreditation organization of Netherlands and Flanders.
- S. State Recognitions and Approvals. Only a few states in the US have individual review processes to approve students to receive clinical rotations, residencies, and licensure in that state; accreditation by these states is typically recognized by other states as well:
- New York State Education Department (NYSED)
- Medical Board of California (MBC)
- Florida Department of Education (FL DOE)
Tiers of Accreditation
Caribbean medical schools are ranked in three tiers (top-tier, middle-tier, and bottom-tier) based on approvals and accreditations. In order to have the greatest options of practicing medicine within the U.S., aim for top-tier programs.
Schools such as St. George’s, Ross, Saba, American University of the Caribbean (AUC) and American University of Antigua (AUA) College of Medicine operate in the top tier and offer a medical education equivalent to that of U.S. schools. All four have been approved by the licensing boards of New York, California, and Florida. AUA, St. George’s, and Ross have also been accredited by CAAM-HP.
These medical schools have thousands of alumni in residency or practicing throughout the U.S. and Canada.
Eligibility for US Funding
In addition, the National Committee on Foreign Medical Education and Accreditation (NCFMEA), within the U.S. Department of Education (DOE), plays a central role in determining whether American students at foreign medical schools are eligible for federal student loans. NCFMEA is not an accreditation agency. Instead, it reviews the standards that a foreign country uses to accredit its medical schools, and determines whether those standards are comparable to the US. If so, any accredited medical school within that country can apply to participate in DOE’s federal student loan program.
U.S. medical schools place strong weight on applicants’ MCAT scores and GPA. Therefore, regardless of your passion for medicine and the strength of your medically related experiences (such as research, shadowing, and community service), if you don’t perform well on these numerical criteria, your chances of acceptance drop dramatically.
While the average MCAT and GPA of applicants to U.S. medical schools has remained fairly constant over recent years, the stats of matriculants has increased, along with the numbers of applicants, showing greater selectivity and therefore competition. While the number of applicants increased 14% from the 2012-13 application year to 2017-18, matriculants only rose 9.3% since medical schools are not significantly adding capacity. Admit rate in just this six-year period dropped from 43% to 41%.
On the other hand, Caribbean medical schools accept students with lower GPAs and MCAT scores and typically do not have minimums. At AUC, the average accepted student’s GPA is 3.27 and the average MCAT is 469. At St. George’s, the average overall GPA for enrolled students entering fall 2016 was 3.3, with the undergraduate science average of 3.2.
Over the past 40 years, St. George’s University has graduated 17,000 alumni and Ross University has graduated 14,000 alumni. At these schools, a 3.4/3.5 gpa is competitive. If you did poorly freshman year, your admission chances at a U.S. medical school decrease, but Caribbean medical schools will consider you.
Now that we have established the rationale for attending Caribbean medical schools, let’s look at how their graduates actually perform. How prepared are they for the practice of medicine, and how is their education valued? Two leading measures are the pass rate for the USMLE (Untied States Medical Licensing Examination) and residency placement, respectively.
The USMLE consists of Step 1, Step 2 Clinical Knowledge, and Step 3. A passing score on all three parts is required to practice medicine in the US. The steps assess the following:
- Step 1: Basic science knowledge that is foundational to the practice of medicine; understanding principles underlying health, disease, and modes of therapy.
- Step 2 Clinical Skills (CS) and Clinical Knowledge (CK): Application of medical knowledge, skills, and understanding of clinical science to provide supervised patient care.
- Step 3: Application of medical knowledge and understanding of biomedical and clinical science to provide unsupervised patient care.
At SGU (St. George’s University School of Medicine) the pass rate in 2017 was an impressive 95% overall, and 95% for US and Canadian students. This compares favorably with the pass rate of 96% at US and Canadian medical schools. The pass rate at SGU has surpassed 95% for five consecutive years. In 2017, the pass rate at other foreign schools was 77%, and the pass rate at US and Canadian DO schools was 95%.
Residency placement is the all-important next step after medical school, on the path to the practice of medicine.
SGU posts its lists of residency placements online. As an example of the quality of placements, for the Class of 2018 graduates who placed in New York, hospitals included top programs such as Albert Einstein, Mount Sinai, and New York University. Specialties consisted of the full range, including anesthesiology, emergency medicine, family medicine, internal medicine, neurology, obstetrics and gynecology, pathology, pediatrics, psychiatry, and surgery.
In 2018, 936 St. George’s University grads procured PGY1 positions. There was 93% residency placement in PGY1 the year of graduation. For U.S. students at Ross University there was 94% residency placement.
Fast Facts – Caribbean Offshore vs. US Medical Schools Features
Selected Top Tier Caribbean Medical Schools
|University||Total Enrollment||Attrition Rate||Median MCAT||Median GPA||Residencies|
|St. George’s University||6,021||10%||497||3.33||937|
|American University of the Caribbean (AUC)||400/ year||13%||496||3.27||
Selected U.S. Medical Schools
|University||Total Enroll||Acceptance Rate||Median MCAT||Median GPA|
|George Washington U||
|New York Medical College||
Factors to Consider
Various factors are important to consider when gauging the quality of the medical education you will receive at a particular Caribbean medical school. Ask the following questions:
- What are the school’s average USLE Step 1 scores?
- How is the curriculum structured?
- What are the mean overall and BCPM (biology, chemistry, physics and math) GPAs and MCATS of accepted students? Are MCATs required to submit an application?
- Where do students complete third and fourth year clerkships?
- Does the Caribbean school encourage away electives?
- What percentage of 4th year students earn residency placements?
- Where and in what specialties did students in the most recent graduating classes match for residency, and what percentage of fourth year students matched into categorical residencies?
Students should always apply to a few of their dream schools, but they should also consult the MSAR (Medical School Admission Requirements), or individual schools’ websites, to determine a list of five to seven additional schools at which they would be competitive grade-wise. Students should also create a list of three or more schools at which their academics are on the very high end, to maximize the chance of securing an acceptance.
Overall, Caribbean medical schools offer less competitive applicants less selective options, a faster application process, and comparable education and residency opportunities as medical schools in the U.S. For many US students, these options provide you with the chance to successfully pursue your passion for a career in medicine.
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